Rapid Aztreonam/Avibactam NP test for detection of aztreonam/avibactam susceptibility/resistance in Enterobacterales.

Details

Serval ID
serval:BIB_13DB72E15498
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Rapid Aztreonam/Avibactam NP test for detection of aztreonam/avibactam susceptibility/resistance in Enterobacterales.
Journal
Journal of clinical microbiology
Author(s)
Viguier C., Bouvier M., Sadek M., Kerbol A., Poirel L., Nordmann P.
ISSN
1098-660X (Electronic)
ISSN-L
0095-1137
Publication state
Published
Issued date
24/10/2023
Peer-reviewed
Oui
Volume
61
Number
10
Pages
e0058823
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Aztreonam-avibactam (AZA), a newly developed β-lactam/β-lactamase inhibitor combination, is a treatment option for infections due to carbapenem-resistant Enterobacterales (CRE), including metallo-ß-lactamase producers, regardless of additional production of broad-spectrum serine-ß-lactamases. However, AZA-resistance has already been reported in Enterobacterales and its early detection could be a valuable tool for faster and more accurate clinical decision-making. We therefore developed a rapid culture-based test for the identification of AZA resistance among multidrug-resistant Enterobacterales. The Rapid Aztreonam/Avibactam NP test is based on resazurin reduction when bacterial growth occurs in the presence of AZA at 8/4 µg/mL (protocol 1) or 12/4 µg/mL (protocol 2). Given the absence of guidelines on AZA susceptibility testing, two tentative breakpoints were indeed used to categorize AZA-susceptible isolates: ≤4 µg/mL in protocol 1 and ≤ 8 µg/mL in protocol 2. Bacterial growth was visually detectable by a blue-to-purple or blue-to-pink color change of the medium. A total of 78 enterobacterial isolates (among which 34 AZA-resistant and 13 AZA-resistant according to protocols 1 and 2, respectively) were used to evaluate the test performance using protocol 1 or protocol 2. The sensitivity and specificity of the test were found to be 100% and 97.7%, respectively, following protocol 1 and 100% and 100%, respectively, following protocol 2, in comparison with broth microdilution. All results were obtained within 4.5 hours corresponding to a time saving of ca. 14 hours compared with currently available methods for AZA susceptibility testing. The Rapid Aztreonam/Avibactam NP test is rapid, highly sensitive, specific, easily interpretable, and easy to implement in routine.
Keywords
Humans, Aztreonam/pharmacology, Anti-Bacterial Agents/pharmacology, Anti-Bacterial Agents/therapeutic use, beta-Lactamases, Azabicyclo Compounds/pharmacology, beta-Lactamase Inhibitors/therapeutic use, Microbial Sensitivity Tests, Drug Combinations, Ceftazidime/pharmacology, Aztreonam-avibactam, Enterobacterales, diagnostics, monobactam, rapid, resistance
Pubmed
Web of science
Create date
06/10/2023 14:27
Last modification date
07/11/2023 7:10
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